Black spots in the lungs are most likely due to diseases such as old scarring, pneumonia, and pulmonary fibrosis. 1. Old scar: when the lung cells are damaged and then repaired, calcified foci in the lungs will be formed, which will show the phenomenon of black spots in the imaging. 2. Pneumonia: when the seriousness of pneumonia leads to complications such as lung abscess, the phenomenon of black shadows in the lungs will appear in the imaging diagnosis of lung CT at this time. 3. Pulmonary fibrosis: pulmonary fibrosis refers to the scarring changes in the lungs caused by abnormal repair after the normal lung tissue has been damaged, which is medically categorized as interstitial lung disease. At this time, fibrosis in the lungs can also present as black spots on imaging. There are other possible causes of black spots on the lungs. Reminder: when black spots appear in the lungs, you should seek medical attention to avoid further progression of the disease.